By Dan Diamond
“I’ve personally seen people working on their resumes inside the office,” the senior official added. “It’s no secret.”
While there are typically a slew of political departures in the run-up to an election, this year’s HHS defections have been unusually prominent and have touched every corner of a health department that’s been barraged by pandemic-linked pressures. Among the exits since the summer: the Centers for Disease Control’s chief of staff, deputy chief of staff and a senior counselor to CDC Director Robert Redfield; the Food and Drug Administration’s top policy official, its top legislative official, top communications official and a senior adviser to FDA Commissioner Stephen Hahn; and the Centers for Medicare and Medicaid Services’ chief of staff and top communications officer.
The White House liaison’s office, which oversees the hiring of political appointees at the health department, itself has turned over — twice — since February.
An HHS spokesperson dismissed questions about the dozens of recent exits and the potential for further departures if Trump isn’t re-elected. “We have no comment on the various hypothetical situations you pose,” the spokesperson said. “Every member of the HHS political team is focused on combating the COVID-19 pandemic and advancing the Trump Administration’s healthcare agenda.”
Many current and former officials told POLITICO that the coronavirus crisis has driven down morale at HHS and its agencies, saying that the round-the-clock nature of the response, unrelenting headlines about the Trump administration’s many fumbles and internal battles over policy have made the health department an especially difficult work environment.
“Those jobs are always hard. Those jobs in a no-win situation are extremely hard. Those jobs in a no-win situation, when there’s sniping and ‘Lord of the Flies’ situations, are impossible,” said a former senior official who left the department in the past year after witnessing feuds that hindered policymaking.
David Mansdoerfer, who served as deputy assistant secretary for health before departing in August 2019 for a job in academia, put it this way: “It’s a tough environment. But a lot of the folks who are leaving now came on early in the administration, and I think they all have great skill sets to add to outside organizations.”
Some officials also have groused that minor mistakes have blossomed into days-long media scandals with little basis in reality, like a recent episode when career CDC officials uploaded draft guidance on how coronavirus spreads in the air before hastily removing it, prompting accusations of political interference. CDC spokespeople said that the guidance was mistakenly posted too soon, and four officials insisted that the speculation of political interference was unfounded — but that it contributed to the unforgiving climate.
“It’s pretty shitty to come to work and be accused of meddling every single time something, somewhere goes wrong, even when no political [appointee] knows about it,” said one official with knowledge of the episode of the botched CDC guidance.
Meanwhile, the White House instituted loyalty tests for all political appointees this summer and has weighed asking for preemptive resignation letters, further aggravating political appointees at HHS who have seen Trump publicly belittle their department’s leaders and work.
Some of those officials are hoping to usher in regime change: Three Trump appointees who left HHS this year told POLITICO that they’re planning to vote for Democratic nominee Joe Biden, with two saying that Trump’s haphazard approach to the coronavirus was a factor in their decision.
“I’ve never voted for a Democrat for president, but Biden hit the sweet spot. I know he’s not too far left and he understands how to make government work,” said one of those former officials, requesting anonymity to speak on the sensitive issue. “And I know he’ll never make fun of [Anthony] Fauci in public,” unlike Trump’s frequent mocking of the health department’s longtime infectious-disease expert.
One fear expressed by some officials: if Democrats capture the White House and also reclaim the Senate, giving the party a relatively free hand to shape policy, demand for Republican health policy experts could wither in the immediate aftermath of a GOP rout in November. The Trump administration’s own record has further complicated searches for traditional jobs with health care associations. While aspects of the administration’s agenda have been warmly received by the industry, like this year’s expansion of telehealth, industry associations have battled with HHS over efforts to repeal Obamacare, impose Medicaid work requirements and change protections for transgender patients, among other clashes.
“‘Trump health official’ already gives people a certain impression, and that’s with the president in office,” said one former official who departed HHS this year and said that landing a high-profile job at many national health associations was a “likely non-starter,” but argued that there are ample opportunities for administration veterans to work for conservative lawmakers, lower-profile policy shops and other firms seeking to understand the regulatory environment.
More officials are eying the exits before Inauguration Day, including senior adviser Danielle Steele, who’s counseled HHS Secretary Alex Azar on issues at FDA and the National Institutes for Health during the pandemic, said three people briefed on Steele’s plans. Steele did not respond to request for comment.
The frustration also extends up to the most senior levels of the health department, where officials like FDA chief Hahn and CDC chief Redfield have been, at turns, isolated and berated for their perceived failings in the coronavirus response. The two men joked about quitting to open a restaurant, The New York Times reported, and they’re expected to face continued pressures regardless of what happens on Election Day; Azar has openly mused about replacing the FDA commissioner after a series of battles over coronavirus-related policies, POLITICO reported this week.
That’s led some officials to anticipate that Hahn and Redfield may voluntarily walk away rather than take the risk of being abruptly fired in a tweet by Trump after the election.
CDC and FDA spokespeople didn’t respond to questions about whether Hahn and Redfield joked about quitting together. “Commissioner Hahn remains focused on the FDA’s important, science-based public health work on behalf of the American public and supporting the agency’s career staff of nearly 18,000 strong,” an FDA spokesperson said.
CDC didn’t respond to a question about Redfield’s future plans.
Azar himself has lamented that his ambitious agenda for HHS this year, which he laid out in a February “State of the Department” address and included objectives like winding down the HIV epidemic and pushing more drug-pricing reforms, has been disrupted by a pandemic that’s affected virtually every corner of department operations, said two people who have spoken with the secretary. Other officials say that HHS continues to try to make progress on a wide array of non-pandemic priorities like payment rules and public health regulations, even if many meetings are being pushed to nights and weekends.
“There’s the part of my job where I respond to coronavirus, and the part of my job where I keep responding to all the rules and regs we’re trying to get out the door,” said one political appointee, describing the current “24/7” nature of the work that “makes it feel like I have two full-time jobs.”
The departures and pace have created further pressure on the remaining staff at agencies like FDA, which is racing to evaluate coronavirus treatments and potential vaccines. “I for one am extremely grateful for the long hours and heroic efforts that my former colleagues have been putting in,” said Lowell Schiller — who was the FDA’s top policy official before stepping down last month to consider new opportunities.
Some current and former officials argued that while the pandemic was creating new pressures, it also had clarified the department’s purpose.
“There is a sense of mission for many around the Covid response,” said John O’Brien, who led drug policy at HHS before leaving last year. “Regardless of the election outcome I think they’ll be there until Inauguration Day trying to get vaccines and treatments out the door.”
Nonetheless, as the election draws closer, HHS has had to scramble to plug an ongoing series of holes.
Robert Weaver, who was Trump’s one-time pick to lead the Indian Health Service before withdrawing from consideration in February 2018 under scrutiny for his qualifications, has spent recent weeks working as a senior adviser to the health department’s White House liaison, according to three officials and the HHS online directory. Weaver, who has dismissed scrutiny of his Indian Health Service candidacy as baseless, did not respond to requests for comments.
Nina Witkofsky, meanwhile, was quickly elevated to be CDC’s acting chief of staff in August after joining the agency just weeks earlier in June. Prior to joining the administration, Witkofsky had served as a communications contractor helping arrange trips for CMS Administrator Seema Verma, being paid under a contract that attracted congressional scrutiny. A CDC spokesperson confirmed Witkofsky’s current role.
Many officials said that they’re allowing for the chance that Trump will win re-election, citing enthusiasm for the president among his core supporters. But those officials also said they’re looking at polls that show Biden with a commanding lead and trying to be realistic about what next month’s election could bring.
“When you speak to folks 1-on-1, it’s pretty clear that everyone has their mindset to ‘we’re on the way out,'” said one official, who is planning to move quickly to line up a new job if the election goes against Trump.